Reablement - Urgent Homecare and Falls Response Service

Reablement - Urgent Homecare and Falls Response Service is a domiciliary care service providing short-term personal care to people needing support to regain their independence after illness or surgery. At the time of this inspection, 59 people were being supported by the service.

Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The manager had made the required improvements to the quality of people’s care plans and risk assessments. This ensured that staff supported people safely to meet their individual needs. The detailed information in the care plans now helped staff to provide person-centred care. The manager now had access to records stored on the provider’s electronic system. This helped them to carry out their role well.

People were happy with how staff supported them to meet their individual needs, and they felt safe. Those who required longer-term support would have preferred to continue being supported by the service. Most people and their relatives described staff as ‘good, caring, friendly and helpful’. There were now systems to ensure that risks to people were well managed.

Communication between people, staff and the manager had improved. People and their relatives told us that they had been involved in planning people’s care. They felt able to contact the manager if they had any concerns. There was a system to manage people’s concerns and complaints.

The provider had systems to regularly assess and monitor the quality of service. This helped them to continually improve the service. The manager and staff worked closely with health professionals to ensure that people received the right care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 June 2019).

Why we inspected

We undertook this focused inspection to check that the provider had made improvements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Reablement – Urgent Homecare and Falls Response Service is a domiciliary service providing personal care to 32 people at the time of the inspection.

Not everyone using Reablement – Urgent Homecare and Falls Response Service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People were happy with the care staff who supported them in the community however communication with office staff and good planning of care was less effective.

People did not feel that complaints were managed well and that they were not listened to by office staff. People told us the service was at times very disorganised due to incorrect rotas and problems related to planning of services. People did not receive a consistent service as the nature of the reablement service is to visit on a day but not at a specific time.

We found that peoples risk assessments were not always sufficiently recorded and information for staff on how to manage risks. People had not come to harm as a result of the concerns around risk management.

People told us they felt safe and thought staff were very kind and caring and did a good job. One person said, “The actual carers themselves were very good they came and stayed as long as I wanted them to and gave suggestions that helped me with what I needed.”

For the people who required it, they were supported well with medicines and food and drink.

People told us staff understood what care and support they required and were well trained. We found staff records in relation to recruitment processes incomplete due to the change from paper to electronic record keeping. People had not been harmed as a result of these incomplete records. The registered manager and human resources team will ensure these records are available and complete in the future.

People told us the care was provided in ways that met their personal preferences and needs.

The service worked with other health professionals such as physiotherapists to enable people to become as independent as possible.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

We have made a recommendation about ensuring records show clear assessment and guidance of managing people’s risks. We have also made a recommendation in relation to recording recruitment documentation.

Rating at last inspection:

At the last inspection the service was rated Good (published 01 September 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 03 August 2016 and was announced. We also carried out telephone interviews on the 08 August 2016, to gain some insight from people who received care from the service and their family members.

The service did not have a registered manager; however they were in the process of interviewing for this post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. In addition, the registered manager was supported by two team leaders, who ensured the smooth running of the service in their absence.

People felt safe when staff from the service came to provide them with care and support. Staff member were trained in safeguarding principles and were able to report abuse if they suspected it. As part of the assessment process, risks to people's health and well-being were assessed and interventions put in place to help reduce the impact of these risks. There were sufficient numbers of staff on shift to meet people's needs and the provider was in a process of recruitment to help further develop the team. Where necessary, staff members were able to provide people with support or prompt them to ensure they took their medication correctly.

Staff members received training to help ensure they had the necessary skills to perform their roles. New staff had an induction to provide them with the basic skills they needed and all staff received additional specialist training to provide them with the skills necessary to carry out assessments of people's needs. Staff sought people's consent before providing them with care and there were systems in place to ensure the principles of the Mental Capacity Act 2005 were adhered to. Staff also supported people to make their own food and drinks if necessary, but promoted independence in this area. The service liaised with a range of healthcare professionals to ensure people received the care they needed.

There were positive relationships between people and members of staff, staff treated people with kindness and compassion and spent time getting to know them whilst providing them with care. People and their family members were involved in planning their care and were provided with information about the service and what they could expect from it. People's privacy and dignity were maintained and staff members worked hard to promote people's independence.

Assessments were carried out on an individual basis to ensure that people received person-centred care. Care plans described people's individual and specific needs and outlined the actions that staff would take to meet them. If people's needs changed while the service was providing them with care, care plans were reviewed and updated to reflect these changes. There was also a robust complaints procedure in place to receive people's comments and feedback, and to take appropriate action to manage complaints.

The service had a positive culture and ethos. People were happy about the care they received from the service and staff were positive and motivated to perform their roles. Staff members wanted to help promote people's independence and support them to live in their own homes safely. Staff felt well supported by the manager and provider and felt they good seek advice when needed. There were checks and audits in place to monitor and analyse the performance of the service and therefore to drive improvements in the care being provided.